The COVID-19 pandemic has rapidly accelerated the adoption of telehealth, with emergency physicians delivering care whenever patients need it, and wherever they are located.
“The genie’s out of the bottle,” said Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma.
It is clear, even after just a few months, that the expansion of telehealth has significantly strengthened emergency care delivery beyond the four walls of the emergency department. As more patients see telehealth as a safe and convenient option, it is hard to imagine ever retreating to the way things were before.
Improving the ability for patients to communicate with their doctors remotely during this national emergency can save lives. At the same time, encouraging telehealth helps emergency physicians protect patients and care teams on the frontlines from exposure to the virus while preserving personal protective equipment.
Some important progress has been made in a remarkably brief time. Emergency physicians are managing testing tents outside of their emergency departments, connecting with patients remotely via video calls, hosting virtual appointments, and more. Still, to make sure that patients continue to get timely, personalized, high-quality care, we need to make sure that federal and state policies keep pace with clinical innovation.
First, Congress should change the Medicare telehealth statute. Once the pandemic ends, CMS loses its ability to grant Medicare the telehealth flexibilities that allow any physician to provide services from any physical location.
Congress can ensure patient access to telehealth after the pandemic by repealing the “originating site” requirement, which forces patients to travel to certain healthcare facilities to receive telehealth services instead of allowing them to receive medical attention from the comfort of their home. CMS has temporarily instituted this change because of COVID-19 and Congress should make it permanent.
All state Medicaid programs and health plans need to follow Medicare’s lead today and innovate going forward. Health plans and states should embrace telehealth with the same enthusiasm as Medicare and align their telehealth policies with Medicare’s to ensure consistent regulation, licensure, billing, and coding for emergency telehealth services. Different billing rules and state regulations make reimbursement inconsistent and adds administrative challenges that hinder the sustainability of these new and vital telehealth programs.
Furthermore, CMS has temporarily allowed emergency physicians to apply emergency department evaluation and management, observation, and critical care codes when performing emergency telehealth services from any location. These billing codes should be permanently added to the list of approved Medicare telehealth services as they appropriately reflect the value and intensity of emergency services and should be used whether care is delivered in-person or via telehealth.
Providing emergency services remotely is safe and effective when the right pieces are in place. Of course, telehealth has its limits and there are times when the best option for a patient will be to visit the closest emergency department.
As more patients receive medical advice remotely, patient education will be even more important. Emergency physicians can work with hospitals and other care providers to help make sure patients know when to go to the emergency department.
Technology is a major part of everyone’s lives now and there is no reason to believe we cannot adopt these tools to improve healthcare. Emergency physicians are leading the way and urge Congress, CMS, and others to help usher in a new era of patient care.
Jeffrey Davis is the director of regulatory affairs for the American College of Emergency Physicians.
Last Updated May 22, 2020